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Affirming health care is life-saving for transgender youth

OHSU will continue to provide safe, evidence-based care for trans, nonbinary youth despite Arkansas law
portrait of Jess Guerriero, M.A., M.S.W., an adult with glasses and a pink bow tie, standing in a medical office speaking to another adult (face not shown)
Jess Guerriero, M.A., M.S.W., is a patient intake and referral specialist for the OHSU Transgender Health Program. (OHSU/Fritz Liedtke)

Imagine yourself as a child or teen. You have repeatedly heard others comment about your access to school bathrooms, your ability to play team sports, your health care and how people like you are being murdered. You breathe a sigh of relief when the president issues an executive order to prevent and combat discrimination based on gender identity or sexual orientation. Even though you live in Oregon, which has been a leader in supporting transgender health care, a new law in another state strips people like you of their right to health care, and removes their ability to see a doctor who really sees who they are. You feel powerless and worthless. You feel betrayed by adults who should protect you and your peers.

We are professionals from the OHSU Transgender Health Program and the OHSU Doernbecher Gender Clinic who have decades of experience treating transgender people of all ages. We use well-researched principles in our patients’ care, prioritizing their safety and well-being above all else, and ensuring support for their whole family. These treatments are not experimental. We have used them for over 50 years. Our program sees more than 600 youth in specialty care and countless more in our primary care clinics. And yet, a recent survey we conducted found 75% of gender-diverse youth in Oregon have never received affirming health care.

The recent passage of transphobic legislation in Arkansas that bans children and teens from accessing gender-affirming health care is distressing and regressive, and puts the lives and well-being of these youth at risk. As social paradigms shift toward more expansive models of gender identity, more youth are identifying as transgender, non-binary or gender fluid. Not every child or teen who identifies as gender diverse will want medical interventions. But, for every youth in Oregon who feels persistent and consistent distress over the incongruence of their body with their gender identity, OHSU will continue to provide safe, evidence-based treatments that relieve that distress and allow that individual to thrive. Gender-affirming care saves lives, and it is under attack.

When transgender and non-binary youth can’t access the care they need, there are devastating consequences. Prior to accessing gender affirming care, some young patients at the Doernbecher Gender Clinic say they experienced worsening depression and even attempted suicide. After receiving appropriate care as children and teens, many of our young adult and adult patients say our care not only saved their lives, but allowed them to succeed in school, become gainfully employed and establish their financial independence.

In Arkansas, stripping young patients of affirming care will have detrimental impacts. Providers there will be forced to decide whether to actively do harm by not providing care or risk losing their license and going to jail.

Children and teens should never be the wedge in politics, and neither should marginalized groups. Gender diverse youth have a right to live healthy and meaningful lives and to make it to adulthood.

Youth in Oregon are undergoing emotional anguish right now because of the new law in Arkansas, as well as others under discussion in 17 other states that target transgender youth. Please publicly support access to safe and affirming care for these youths.

Jess Guerriero, M.A., M.S.W., is a patient intake and referral specialist with the OHSU Transgender Health Program. Kara Connelly, M.D., is an associate professor of pediatrics in the OHSU School of Medicine and medical director of  the OHSU Doernbecher Gender Clinic. Christina Milano, M.D., is an associate professor of family medicine in the OHSU School of Medicine, as well as co-founder and medical director of OHSU Transgender Health Program. Hayley Baines, M.D., is an assistant professor of pediatrics in the OHSU School of Medicine. Danielle Moyer, Ph.D., is an assistant professor of pediatrics in the OHSU School of Medicine and director of psychology for the OHSU Doernbecher Gender Clinic.  Amy Penkin, M.S.W., L.C.S.W., is the OHSU Transgender Health Program coordinator.

This viewpoint was originally published April 19, 2021, by the Portland Tribune.

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